Dural tears can occur during spinal surgery and may lead to cerebrospinal fluid (CSF) leakage which is rarely involved in remote cerebellar hemorrhage. Only a few of cases of simultaneous cerebral and cerebellar hemorrhage have been reported in the English literature. We experienced a case of multiple remote cerebral and cerebellar hemorrhages in a 63-year-old man who exhibited no significant neurologic deficits after spinal surgery. Magnetic resonance imaging (MRI) performed 4 days after the surgery showed a large amount of CSF leakage in the lumbosacral space. The patient underwent the second surgery for primary repair of the dural defect, but complained of headache after dural repair surgery. Brain MRI taken 6 days after the dural repair surgery revealed multifocal remote intracerebral and cerebellar hemorrhages in the right temporal lobe and both cerebellar hemispheres. We recommend diagnostic imaging to secure early identification and treatment of this complication in order to prevent serious neurologic deficits.
Brain ; Diagnostic Imaging ; Headache ; Hemorrhage ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Neurologic Manifestations ; Temporal Lobe

Dural tears can occur during spinal surgery and may lead to cerebrospinal fluid (CSF) leakage which is rarely involved in remote cerebellar hemorrhage. Only a few of cases of simultaneous cerebral and cerebellar hemorrhage have been reported in the English literature. We experienced a case of multiple remote cerebral and cerebellar hemorrhages in a 63-year-old man who exhibited no significant neurologic deficits after spinal surgery. Magnetic resonance imaging (MRI) performed 4 days after the surgery showed a large amount of CSF leakage in the lumbosacral space. The patient underwent the second surgery for primary repair of the dural defect, but complained of headache after dural repair surgery. Brain MRI taken 6 days after the dural repair surgery revealed multifocal remote intracerebral and cerebellar hemorrhages in the right temporal lobe and both cerebellar hemispheres. We recommend diagnostic imaging to secure early identification and treatment of this complication in order to prevent serious neurologic deficits.
Brain ; Diagnostic Imaging ; Headache ; Hemorrhage ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Neurologic Manifestations ; Temporal Lobe

Pigmented Spitz nevus is a benign melanocytic skin lesion with distinct clinical features and it is frequently found on the extremities. However, it rarely occurs on acral area of the body, and such a case has not yet been fully documented. We present a case of acral pigmented Spitz nevus occurring on the foot, and this mimicked acral lentiginous malignant melanoma. Clinicians should be well aware of this entity and its possible clinical presentations. Since acral pigmented Spitz nevus is benign in nature, making the correct diagnosis is important to avoid unnecessary mutilating or excessive surgery.
Extremities ; Foot ; Melanoma ; Nevus, Epithelioid and Spindle Cell ; Skin

Central serous chorioretinopathy (CSCR) is an idiopathic disorder characterized by serous detachment of the macula and retinal pigment epithelial (RPE) detachment. Its etiology and pathophysiology are still unknown. However, CSCR can arise secondary to chronic treatment with steroids. We present two cases in which CSCR developed in patients on oral steroid therapy and resolved after treatment was stopped. We also offer a review of the literature.
Central Serous Chorioretinopathy ; Glomerulonephritis ; Humans ; Retinaldehyde ; Steroids

No abstract available.
Axons ; Hand ; Humans

An 18-year-old man suffered heat stroke after continuous working for 26 hours on his first day in an aluminium utensil plant in August 1998. His job was to put a pressed aluminium utensil on the conveyer before the process of spray painting. The ranges of temperature and relative humidity measured at the local weather-station during the patient' s working period were 23.6-30.2 degrees C, 49-87 % respectively. On arrival the patient was comatose and suffered generalized seizure three times. His rectal temperature was 41.2 degrees C . blood pressure was 90/60 mmHg, pulse was 148 beats/minute and respiratory rate was 28 times/minute. The serum level of AST was 421 IU/L. ALT was 205 IU/L, LDH was 1,160 IU/L. myoglobin was higher than 500 ng/mL. OK was higher than 2,000 IU/L. He recovered consciousness 7th day of admission and discharged after 2 months but cerebellar dysarthria was remained. The patient felt himself several prodromal symptoms of heat stroke and he showed awkward behavior considered to be drowsiness, but the patient and his co-workers neglected them. This case report shows that heat stroke can be occurred in a condition that ambient temperature, humidity, and working load are not extreme. A thorough health education and management concerned with guidelines on salt and water intake, detection of early symptoms of heat-related illness, prompt body cooling and rapid transportation to a hospital is necessary.
Adolescent ; Blood Pressure ; Coma ; Consciousness ; Drinking ; Dysarthria ; Health Education ; Heat Stroke* ; Hot Temperature* ; Humans ; Humidity ; Myoglobin ; Paint ; Paintings ; Plants* ; Prodromal Symptoms ; Respiratory Rate ; Seizures ; Sleep Stages ; Transportation

PURPOSE: The aim of this study was to investigate whether the observed changes over time in the survival rates vary according to the intrinsic subtypes of breast cancer diagnosed. METHODS: Data from 46,320 breast cancer patients in the Korean Breast Cancer Registry who underwent surgery between 1999 and 2006 were reviewed. Among them, results from 25,887 patients with available data about the status of estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 (HER2) were analyzed. Patients were classified into two cohorts according to the year in which they underwent surgery: 1999-2002 and 2003-2006. RESULTS: The patients treated in the latter time period showed significantly better overall survival (OS) compared with those in the former period when adjusted for follow-up duration. The proportion of hormone receptor+/HER2-subtype and stage I breast cancer were significantly higher in the latter period (47.4% vs. 54.6%, p<0.001; 31.0% vs. 39.6%, p<0.001, respectively). Improvement in OS between the former and latter periods was seen in all subtypes of breast cancer, including triple-negative cancers (all p-values <0.001 in univariate and multivariate analyses). CONCLUSION: Improvement in survival in Korean breast cancer patients over the study years is being observed in all subtypes of breast cancer, implying that increases in both early-stage detection and the proportion of less aggressive cancers contribute to this improvement.
Breast Neoplasms* ; Cohort Studies ; Estrogens ; Follow-Up Studies ; Humans ; Korea ; Receptor, Epidermal Growth Factor ; Receptors, Progesterone ; Registries ; Survival Rate

Xanthogranulomatous pyelonephritis (XP) is an uncommon, chronic, destructive, granulomatous disease of the renal parenchyma. The condition is generally associated with long-term urinary tract obstruction and infection, although the precise etiology of disease remains unknown. The condition often mimics neoplastic and inflammatory diseases, and XP associated with actinomycosis is extremely uncommon. A 60 year-old male was admitted complaining of abdominal pain and weight loss. His radiological findings were suggestive of metastatic kidney cancer, and we performed radical laparoscopic nephrectomy and mesenterectomy for diagnostic purposes. Pathologically, actinomycosis combined with XP was evident. We report here a rare case of XP associated with actinomycosis.
Abdominal Pain ; Actinomycosis* ; Humans ; Kidney Neoplasms* ; Kidney* ; Male ; Nephrectomy ; Pyelonephritis ; Pyelonephritis, Xanthogranulomatous* ; Urinary Tract ; Weight Loss

PURPOSE: The purpose of this study was to investigate the accuracy and reliability of the semi-automated ultrasonographic volume measurement tool, virtual organ computer-aided analysis (VOCAL), for measuring the volume of parathyroid glands. METHODS: Volume measurements for 40 parathyroid glands were performed in patients with secondary hyperparathyroidism caused by chronic renal failure. The volume of the parathyroid glands was measured twice by experienced radiologists by two-dimensional (2D) and three-dimensional (3D) methods using conventional sonograms and the VOCAL with 30°angle increments before parathyroidectomy. The specimen volume was also measured postoperatively. Intraclass correlation coefficients (ICCs) and the absolute percentage error were used for estimating the reproducibility and accuracy of the two different methods. RESULTS: The ICC value between two measurements of the 2D method and the 3D method was 0.956 and 0.999, respectively. The mean absolute percentage error of the 2D method and the 3D VOCAL technique was 29.56% and 5.78%, respectively. For accuracy and reliability, the plots of the 3D method showed a more compact distribution than those of the 2D method on the Bland-Altman graph. CONCLUSION: The rotational VOCAL method for measuring the parathyroid gland is more accurate and reliable than the conventional 2D measurement. This VOCAL method could be used as a more reliable follow-up imaging modality in a patient with hyperparathyroidism.
Follow-Up Studies ; Humans ; Hyperparathyroidism ; Hyperparathyroidism, Secondary* ; Imaging, Three-Dimensional ; Kidney Failure, Chronic ; Methods* ; Organ Size ; Parathyroid Glands ; Parathyroidectomy ; Ultrasonography